(R)- and (S)-methadone and buprenorphine concentration ratios in maternal and umbilical cord plasma following chronic maintenance dosing in pregnancy
Date
2010
Authors
Gordon, A.
Lopatko, O.
Somogyi, A.
Foster, D.
White, J.
Editors
Advisors
Journal Title
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Volume Title
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Journal article
Citation
British Journal of Clinical Pharmacology, 2010; 70(6):895-902
Statement of Responsibility
Andrea L. Gordon, Olga V. Lopatko, Andrew A. Somogyi, David J. R. Foster & Jason M. White
Conference Name
Abstract
AIMS The aim of this study was to compare the transfer of buprenorphine and methadone between maternal and cord blood in women under chronic dosing conditions and to determine if differences exist in the transfer of the two methadone enantiomers. METHODS Maternal and cord blood samples were collected at delivery from women maintained on methadone (35, 25-140 mg day-1) (median; range) or buprenorphine (6.00, 2-20 mg day-1) during pregnancy. Plasma concentration ratios are presented as an indicator of foetal exposure relative to the mother. RESULTS Methadone was quantified in all samples, with cord : maternal plasma methadone concentration ratios (n= 15 mother-infant pairs) being significantly higher (P < 0.0001; mean difference (MD) 0.07; 95% confidence interval (CI) 0.048, 0.092) for the active (R)-methadone enantiomer (0.41; 0.19, 0.56) (median; range) compared with (S)-methadone (0.36; 0.15, 0.53). (R)- : (S)-methadone concentration ratios were also significantly higher (P < 0.0001; MD 0.24 95% CI 0.300, 0.180) for cord (1.40; 0.95, 1.67) compared with maternal plasma (1.16; 0.81, 1.38). Half the infant buprenorphine samples were below the assay lower limit of quantification (LLOQ) (0.125 ng ml-1). The latter was four-fold lower than the LLOQ for methadone (0.50 ng ml-1). The cord : maternal plasma buprenorphine concentration ratio (n= 9 mother-infant pairs) was 0.35; 0.14, 0.47 and for norbuprenorphine 0.49; 0.24, 0.91. CONCLUSIONS The transfer of the individual methadone enantiomers to the foetal circulation is stereoselective. Infants born to buprenorphine maintained women are not exposed to a greater proportion of the maternal dose compared with methadone and may be exposed to relatively less of the maternal dose compared with infants born to women maintained on methadone during pregnancy.
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Link to a related website: http://europepmc.org/articles/pmc3014073?pdf=render, Open Access via Unpaywall
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© 2010 The Authors. British Journal of Clinical Pharmacology © 2010 The British Pharmacological Society